Imajin, sɔmbɔdi we de bifo yu nɔ no natin wantɛm wantɛm ɛn fɔdɔm na grɔn. Yu de rɔn rawnd wit fred ɛn chɛk dɛn nɛk fɔ si if dɛn gɛt puls, bɔt puls nɔ de. I tan lɛk se dɛn nɔ de blo. Yu tink se dis na kadyak arest. Bɔt i sɔprayz fɔ no se we dɛn kɛr dɛn go na ɔspitul, di dɔktɔ dɛn kin tek ECG ɛn i kin sho se ilɛktrik de wok na di at. Ilɛktrishɔn de, bɔt di at nɔ de bit. Dis strenj, denja kɔndishɔn na wetin wi na mɛrɛsin kɔl "Pulseless Electrical Activity". Wi de kɔl am PEA fɔ shɔt tɛm. Dis na tin we rili impɔtant. So, lɛ wi tɔk bɔt dis simpul wan.
Fɔ tɔk am simpul wan, wetin na PEA?
PEA na wan kayn we aw yu at kin stɔp. Wetin kin apin ya na dat, pan ɔl we ilɛktrik de wok na di at, di at mɔsul nɔ kin kɔntrakt ɛn pɔmp blɔd akɔdin to da ilɛktrik signal de. I tan lɛk se di layt bɔl nɔ de ɔn bikɔs di filament dɔn bɔn pan ɔl we ilɛktrishɔn de .
Dɛn kin mɛzhɔ dis ilɛktrik aktiviti wit ECG (ilɛktrokardiogram). Bɔt we yu luk yu puls, yu nɔ go fil puls bikɔs di at nɔ de bit ɛn pɔmp blɔd rawnd di bɔdi.
di mכst imכtant, PEA na "nonshockable" hat ritm patεn. Dis min se i nɔ go ebul fɔ kam bak bay we pɔsin shɔk frɔm difibrilator, lɛk aw dɛn sho am na di fim dɛn. So, if dɛn nɔ gɛt di rayt tritmɛnt kwik kwik wan, pɔsin kin day insay sɔm minit.
Tu kayn PEA de
Dɔktɔ dɛn kin sheb dis to tu men kayn.
1. Pseudo-PEA: insay dis, di at mכsul de kכntrakt bכku bכku wan bikoz fכ di ilektrikal aktiviti we di at de du. Ivin if i de pɔmp smɔl blɔd, i nɔ strɔng lɛk aw nɔmal at bit. So, nɔto inof blɔd de flɔ fɔ fil wan puls na di bɔdi.
2. Tru PEA: Insay dis, pan ɔl we ilɛktrik de na di at, di at mɔsul nɔ de ansa atɔl . Dat min se dɛn nɔ de pɔmp ɛni blɔd atɔl. Nɔ puls nɔ de fil atɔl.
Wetin na di difrɛns bitwin PEA ɛn Asystole (Flat-lining)?
Yu go mɔs dɔn si am na fim, we pɔsin day, wan stret layn de apia na di monita wit "bip..." sawnd. Na dat wi kin kɔl `(asystole)` ɔ "flat-lining."
- PEA: Ilɛktrishɔn de na di at, bɔt di at nɔ de wok. (Jɔs lɛk TV we gɛt kɔrɛnt , bɔt i dɔn brok).
- Asystole: Di at nɔ gɛt ilɛktrishɔn, ɛn di at nɔ de bit. I stil stil de kpatakpata. (Lɛk TV we dɛn dɔn pul di plɔg).
Pan ɔl we dɛn ɔl tu na kes dɛm we di at kin stɔp, dɛn kin no di difrɛns bay aw di ECG tan.
Wetin na di men tin dɛn we kin mek pɔsin gɛt PEA?
Bɔku tin dɛn de we kin mek pɔsin gɛt PEA. Fɔ mek i izi fɔ mɛmba dɛn tin ya, dɔktɔ dɛn kin yuz wan shɔthand sistɛm we dɛn kɔl "H's and T's." Lɛ wi tek wan luk pan wetin dɛn bi.
| Koz Kategori | Simpul Ɛksplen |
|---|---|
| Di blɔd we de go dɔŋ (Hypovolemia) . | Di blɔd we de na di bɔdi we de go dɔŋ bikɔs ɔf sɔntin lɛk we i de blɔd pasmak we i gɛt big aksidɛnt ɔ we i nɔ gɛt wata bad bad wan. |
| Di ɔksijɛn lɛvɛl we de go dɔŋ (Hypoxia) . | Ɔksijɛn nɔ de na di bɔdi bikɔs i nɔ izi fɔ blo ɛn i de drawn. |
| di chenj dεm we de apin na di bכdi in asid/sכlt bεlε (Hydrogen ion - Acidosis) . | di asid we de go ɔp na di bɔdi bikɔs ɔf rizin dɛn lɛk we di kidni nɔ de wok fayn. siriכs chenj dεm na di ilektrolayt lεvεl dεm lεk potashכm. |
| Di tɛmpracha we di bɔdi de go dɔŋ (Hypothermia) . | di bכdi tεmprachכ de dכn to wan rili lכw lεvεl. |
| We pɔsin it pɔyzin | Fɔ tek sɔm mɛrɛsin dɛn, drɔgs, ɔ ɔda tin dɛn we gɛt pɔyzin pasmak. |
| Fluid akyumyuleshכn rawnd di at (Tamponade - kadyak) . | di kכva we de rawnd di at kin fulכp wit blכd כ כda wata, we kin mek di at prεshכn. Dis kin mek di at nɔ de bit fri wan. |
| Tɛnshɔn nyumotɔraks | wan lכng de bכs, i de fulכp di chεst kכva wit briz, i de kכmprεs di at εn di bכdi vεsεl dεm. |
| Blɔd we de klɔt (Trombosis) . | wan kכndyushכn lεk hat atak (`myocardial infarction`) כ bכdi we de kכlכt na di lכng (`pulmonary embolism`). |
| Injury na yu bɔdi (Trauma) . | At damej bikɔs ɔf wan bad bad aksidɛnt na di chɛst. |
Aw dɛn kin trit dis?
We pɔsin gɛt PEA, i kin at fɔ no if i gɛt am na do na ɔspitul, bikɔs i nɔ pɔsibul fɔ no if dɛn nɔ gɛt ECG. Laki, di fɔs ɛn impɔtant tin fɔ du pan ɛni kes we di at nɔ de wok na wan tin: CPR (Cardiopulmonary Resuscitation).
1. Start CPR wantɛm wantɛm: If pɔsin nɔ no natin, i nɔ gɛt puls ɔ i nɔ de blo, kɔl ambulans wantɛm wantɛm ɛn kɔntinyu fɔ kɔmprɛs in chɛst te i kam. Dis na di bɛst chans fɔ sev pɔsin in layf. If yu nɔ no aw fɔ du CPR, di imejensi savis dɛn kin tɛl yu aw fɔ du am.
2. Tritmɛnt na di ɔspitul: Afta dɛn dɔn admit dɛn na di ɔspitul in Imejɛnsi Tritmɛnt Yunit (ETU), di dɔktɔ dɛn go kɔntinyu fɔ du CPR ɛn bigin fɔ du ɔda tritmɛnt dɛn.
- Epinephrine: Dɛn kin kɔl dis bak adrenaline. Dɛn kin gi dis mɛrɛsin fɔ tray fɔ mek di at kam bak to di nɔmal ritm.
- Fɔ trit di kɔz: I impɔtant fɔ no kwik kwik wan wetin mek di PEA (wan pan di kɔz dɛm na di tebul we de ɔp) ɛn trit am. Fɔ ɛgzampul, if blɔd de lɔs, gi blɔd, if ɔksijɛn nɔ de, gi ɔksijɛn, if blɔd de rawnd di at, pul am wit sirinj.
Mɛmba se PEA na "nonshockable" ritm. Dis min se we pɔsin shɔk frɔm difibrilator nɔ go ɛp. כltu, wit gud CPR, sכmtεm di at ritm kin chenj to wan ritm we de shok (e.g., `ventricular fibrillation`). Da tɛm de, wan shɔk we pɔsin kin gɛt frɔm difibrilator kin gi di at chans fɔ bigin bak. Dis na di rizin we mek CPR rili impɔtant.
Wetin wi fɔ du we tin nɔ izi fɔ wi?
Di at we pɔsin kin gɛt na mɛrɛsin ɔltɛm, so i impɔtant fɔ du sɔntin wantɛm wantɛm.
Sɔmbɔdi we de bifo yu:
- If yu nɔ no natin wantɛm wantɛm ɛn fɔdɔm, .
- If yu nɔ ebul fɔ fil puls na yu nɛk ɔ yu an, .
- If yu nɔ ebul fɔ blo ɔ i nɔ izi fɔ yu fɔ blo, .
Kɔl ambulans wantɛm wantɛm. Dɔn, bigin fɔ du CPR kwik kwik wan. Ɛni sɛkɔn kin kɔnt.
Pan ɔl we PEA na wan sik we rili siriɔs, wi ɔndastandin bɔt am dɔn bɔku bɔku wan wit di advansmɛnt fɔ di mɔdan mɛrɛsin. Bɔt di fɔs minit dɛn rili impɔtant pas ɔl dɛn tin ya. So, if yu si pɔsin de gɛt dis, nɔ panik, bigin fɔ du CPR wantɛm wantɛm, ɛn gɛt dɔktɔ ɛp kwik kwik wan, we kin rili mek yu sev yu layf mɔ.
Mɛsej we dɛn kin kɛr go na os
- PEA na wan rili siriɔs mɛdikal imejensi we di at gɛt ilɛktrik aktiviti bɔt nɔ gɛt puls.
- If pɔsin fɔdɔm wantɛm wantɛm ɛn nɔ no natin, chɛk in puls ɛn briz wantɛm wantɛm.
- If puls ɔ brith nɔ de, kɔl ambulans we yu nɔ de te ɛn bigin CPR (chɛst kɔmpreshɔn) wantɛm wantɛm.
- Pan ɔl we shɔk tritmɛnt (defibrillation) fɔ PEA nɔ kin wok fayn, kɔntinyu CPR kin ebul fɔ chenj di at to wan ritm we kin shɔk.
- Di men gol fɔ tritmɛnt na di ɔspitul na fɔ fɛn ɛn trit di ɔndalayn kɔz fɔ di PEA we dɛn de du CPR.
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